A Prescription for West Baltimore

January 21, 1995|By MARILYN McCRAVEN

Several years ago, I was sitting in a West Baltimore hospital emergency room holding my then 1-year-old son -- who had dived out of his crib onto the hardwood floor -- when I truly came to understand what the term ''underserved'' meant regarding health care. After my son was briefly examined to rule out a concussion, we were forced to wait about four hours before he was given a CAT scan and cleared to go home.

It was immediately clear why we had to wait so long. The emergency-room staff was practicing triage, taking the people who had potentially life-threatening conditions first. So my baby -- made crankier than usual by the bump on his head -- and the 10-year-old seated next to us with the broken arm were given low priority.

Suddenly, all the bureaucratic terms I had heard used to describe many inner-city areas rang clear. Neighborhood physicians have abandoned the inner city, leaving hospital emergency rooms in areas such as mine crowded with people who probably wouldn't be there if they had their own doctor.

It's a costly problem. First, in poor health and lives lost because of a lack of care. Second, we all pay for poor people's free emergency-room care through higher taxes, hospital bills and health insurance premiums.

With that in mind, the University of Maryland Hospital is hoping to fill a void and save lots of money by opening a new health-care facility, called UniversityCare, on February 1 in the Edmondson Village Shopping Center in West Baltimore.

The health center -- the first of five to seven such facilities planned for the Baltimore metropolitan area -- will offer comprehensive care, including general practitioners and such specialists as obstetricians, dentists, psychiatrists and pediatricians.

While the facility will be open to anyone, it's particularly eager to attract Medicaid patients and others without private health insurance. Some 35 percent of West Baltimore residents are Medicaid recipients.

Like traditional clinics, it will have a sliding-fee payment scale for those without insurance. But unlike clinics, patients will see the same doctor each time. ''We want it to look like a regular doctor's office,'' Joel Lee, a University of Maryland Hospital vice president, told me.

The emphasis will be on prevention. The facility will dispatch health-care workers to make home visits, especially for those who suffer from such chronic diseases as high blood pressure and diabetes. Pregnant women will be monitored closely to help avoid complications.

Health-care workers will instruct patients in how to help maintain their health by not smoking, eating healthily and getting proper exercise.

Most impressively, hospital officials arrived at this concept by talking to neighborhood leaders and conducting focus groups with neighbor- hood residents. They didn't want to give the community something it didn't want.

It's also probably instructive to government officials that these changes are coming even without a national health-care plan.

Nancy Fiedler, spokeswoman for the Maryland Hospital Association, says she expects more local hospitals to follow suit and begin providing medical ''resources to the neighborhoods'' most in need of health care.

University Hospital is spending $2 million to renovate and outfit the old Hochschild Kohn department store for the center; most recently it was home to a discount children's store.

Retailers in the strip mall apparently are optimistic that the health center will help attract more customers to their businesses. Already, stores there are sprucing up and expanding in anticipation.

Eventually, the facility is to have an ''urgent-care facility'' -- a step between a primary-care center and an emergency room. It will handle broken bones, fevers, etc., for half the cost of an emergency room visit. I wish that had been there for me and my daredevil toddler.